Selected monographs.

  • Kussmaul, Adolf, 1822-1902.
Date:
1859
Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    have accomplished tliis aim, how far the question may be con- sidered as settled by experiments on the healing process after resection. A. Resections in long hones.—Klencke^ and Heine excised por- tions out of the shaft of one of the tubular bones without carrying the section completely tlirough its whole thickness, the former on birds, the latter on dogs, and found in all cases complete restora- tion of the loss of substance by new bony material. Klencke believes that the soft parts surrounding the bone, as well as the periosteum, are capable, either of them by itself, of fui'nisliing the exudation necessary for this restoration. The grounds for this assertion are not, however, satisfactory. Thus, he concludes that the exudation is sometimes furnished by the soft parts from tliis fact: that he has seen, twelve days after the operation, a gelatinous extravasation connected with the soft parts, which was extended across the loss of substance in the manner of a bridge, and showed a fibrous transformation at its edges. That the periosteum alone may furnish the exudation, he concludes from the fact that in another case the periosteum was very vascular and covered the material of the callus, while the soft parts were hardly at all adherent to the bone. Klencke has always found the medullary cavity corresponding to the excised portion of bone completely closed by new bony material, and the hole occasioned by the operation materially altered ia its form by the absorption of its bony edges. Heine observed only a hardly perceptible narrowing of the medullary cavity corresponding to the situation of the resection. After an operation on the tliigh- bone, he found necrosis of the cut edges of the bone, to which a sinus led through the callus-material which, although the interval was only twelve days, had been already deposited around the whole of the femur. After resection of the whole thickness of portions of long bones Heiae has observed, as early as about two months after the opera- tion, complete restoration by bony material in all the cases in which he had been careful to save the periosteum, and in the opposite case rounding ofl' of the resected extremities by new bony material, and in operations on hmbs having two bones, union of them to the neighbouring bone on which callus-material was also de- posited. This was either without any connecting tissue between ' Loc. cit., p. 163. 10